Buttress retention system for linear endostaplers

ABSTRACT

An end effector for use with a surgical stapler comprising a staple cartridge having a tissue contacting surface, a first side surface, and a second side surface opposite the first side surface, an anvil plate having a tissue contacting surface, a first side surface, and a second side surface opposite the first side surface, wherein the first and second side surfaces of each of the staple cartridge and anvil plate have overmolded zones, a buttress releasably disposed on the tissue contacting surfaces of each of the staple cartridge and the anvil plate, and a pair of sutures wherein each suture is bonded to the respective overmolded zones of the first and second side surfaces configured to retain the respective buttress atop the respective tissue contacting surfaces.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a Continuation Application claiming thebenefit of and priority to U.S. patent application Ser. No. 13/404,134,filed Feb. 24, 2012, the entire disclosure of which is incorporated byreference herein.

BACKGROUND

1. Technical field

The present disclosure relates to a surgical stapling apparatus and,more particularly, to a surgical stapling apparatus including an anchormember or members affixed to at least one of an anvil plate and staplecartridge to secure one or more buttresses thereto.

2. Background Of Related Art

Surgical stapling instruments that are used to sequentially orsimultaneously apply one or more rows of fasteners to join segments ofbody tissues are well known in the art. The fasteners are typically inthe form of surgical staples but two part polymeric fasteners can alsobe utilized. Such devices generally include a pair of jaws to clamp thebody tissues between such jaws. Typically, one of the jaw membersincludes a staple cartridge which accommodates a plurality of staplesarranged in one or more rows while the other jaw member has an anvilplate that defines a surface for forming the staple legs as the staplesare driven from the staple cartridge against the anvil.

Certain surgical staplers have elongate jaws that apply linear rows ofstaples to tissue. When such a stapling instrument is actuated, alongitudinally translating actuation member contacts staple drivemembers in one of the jaws which in turn acts upon staple pushers tosequentially eject the staples from the staple cartridge. For example,longitudinally traveling cam bar members can be used to interact withthe staple drive members. Alternatively, the staples can be drivensimultaneously. A blade can travel between the staple rows tolongitudinally cut and/or open the stapled tissue between the rows ofstaples. Such instruments are disclosed, for example, in U.S. Pat. No.3,079,606 and U.S. Pat. No. 3,490,675.

When stapling relatively thin or fragile tissues, it may be important toeffectively seal the staple line against air or fluid leakage.Additionally, it may be necessary to reinforce the staple line againstthe tissue to prevent tears in the tissue or pulling of the staplesthrough the tissue. One method of preventing tears or pull throughinvolves the placement of a biocompatible fabric reinforcing material,or a “buttress,” between the staple and the underlying tissue. In thismethod, a layer of buttress is placed against the tissue and the tissueis stapled in a conventional manner. Surgical staplers utilizing pins orclips to temporarily connect buttresses to each of the jaws of thestaplers, i.e., one disposed on the staple cartridge and the other onthe anvil plate, are known.

The present application discloses a retention system for securing one ormore buttresses to the jaws of the stapler. The retention system allowsthe buttresses to be secured to a tissue contacting surface of thestaple cartridge and anvil plate. This retention system reducesmanufacturing costs associated with surgical staplers. Further, thisretention system diminishes the likelihood of premature suture releaseduring assembly, packing or firing. Fewer design and testing constraintswill be imposed as less precision is required to achieve acceptablefunctioning retention elements.

SUMMARY

The present application discloses an end effector for use with asurgical stapler, the end effector comprising a staple cartridgeassembly having a tissue contacting surface, a first side surface, and asecond side surface opposite the first side surface, an anvil assemblyhaving a tissue contacting surface, a first side surface, and a secondside surface opposite the first side surface, the staple cartridgeassembly and anvil assembly having proximal and distal attachment zones.A buttress is releasably disposed on the tissue contacting surfaces ofeach of the staple cartridge assembly and anvil assembly, and a pair ofanchor members are affixed to the attachment zones of each of the staplecartridge assembly and anvil assembly and are configured to retain therespective buttress material atop the respective tissue contactingsurfaces. In certain embodiments, one of the staple cartridge assemblyand anvil assembly has a buttress material releasably attached thereto.

In certain embodiments, the first and second side surfaces of each ofthe staple cartridge assembly and anvil assembly have overmolded zones,a buttress releasably disposed on the tissue contacting surfaces of eachof the staple cartridge and the anvil plate, and a pair of anchormembers wherein each anchor member is bonded to the respectiveovermolded zones of the first and second side surfaces configured toretain the respective buttress atop the respective tissue contactingsurfaces. Preferably, the overmolded zones are made from polymericmaterial. Alternatively, attachment zones may be composed of press fitparts that are attached to the anvil assembly, or attachment zones maybe composed of molded features integral to the cartridge assembly. Theanchor member is desirably a polymeric suture. A proximal suture ispositioned along a proximal portion of each of the staple cartridgeassembly and anvil assembly, and a distal suture is positioned along adistal portion of each of the staple cartridge assembly and the anvilassembly. A first end of the proximal suture couples to the overmoldedzone of the first side surface and a second end of the proximal suturecouples to the overmolded zone of the second side surface. The proximalsuture passes transversely across a proximal portion of the buttressesof each of the staple cartridge assembly and anvil assembly. Similarly,a first end of the distal suture couples to the overmolded zone of thefirst side surface and a second end of the distal suture couples to theovermolded zone of the second side surface. The distal suture passestransversely across the distal portion of the buttresses of each of thestaple cartridge assembly and anvil assembly.

The staple cartridge assembly and the anvil assembly have a centrallongitudinal slot configured to enable a passage of a knife bladetherethrough. The proximal suture is positioned distally from a proximalend of the central longitudinal slot on each of the staple cartridgeassembly and anvil assembly. The distal suture is positioned proximallyfrom a distal end of the central longitudinal slot on each of the staplecartridge assembly and anvil assembly.

In a further aspect, an end effector for use with a surgical stapler,the end effector comprising: a staple cartridge having a tissuecontacting surface, a first side surface and a second side surfaceopposite the first side surface, wherein the first and second sidesurfaces have overmolded zones disposed near a proximal and distalportion thereof; and an anvil plate having a tissue contacting surface,a first side surface and a second side surface opposite the first sidesurface, wherein the first and second side surfaces have overmoldedzones disposed near a proximal and distal portion thereof. A buttressmaterial is releasably disposed on the tissue contacting surfaces ofeach of the staple cartridge and the anvil plate. The end effector has apair of sutures, wherein each suture is bonded to the respectiveovermolded zones of the first and second side surfaces of each of thestaple cartridge and anvil plate.

A proximal suture may be positioned along the proximal portion of eachof the staple cartridge and anvil plate, and a distal suture may bepositioned along the distal portion of each of the staple cartridge andthe anvil plate. A first end of the proximal suture may couple to theovermolded zone of the first side surface and a second end of theproximal suture may couple to the overmolded zone of the second sidesurface such that the proximal suture passes transversely across aproximal portion of the buttresses of each of the staple cartridge andanvil plate. A first end of the distal suture may couple to theovermolded zone of the first side surface and a second end of the distalsuture may couple to the overmolded zone of the second side surface suchthat the distal suture passes transversely across the distal portion ofthe buttresses of each of the staple cartridge and anvil plate.

In certain embodiments, the staple cartridge and the anvil plate have acentral longitudinal slot configured to enable passage of a knife bladetherethrough. The proximal suture may be positioned distally from aproximal end of the central longitudinal slot on each of the staplecartridge and anvil plate.

The distal suture may be positioned proximally to a distal end of thecentral longitudinal slot on each of the staple cartridge and anvilplate.

DESCRIPTION OF THE DRAWINGS

Various embodiments of the presently disclosed interlocking buttressretention systems are disclosed herein with reference to the drawings,wherein:

FIG. 1 is a perspective view of a surgical stapling apparatus accordingto an embodiment of the present disclosure;

FIG. 2 is a top, exploded, perspective view of a distal end of thesurgical stapling apparatus of FIG. 1;

FIG. 3 is a perspective view of a cartridge assembly of FIG. 2,illustrating a cartridge buttress material secured thereto;

FIG. 4 is a perspective view of an anvil assembly of FIG. 2,illustrating an anvil buttress material secured thereto; and

FIG. 5 is a perspective view of a cartridge assembly and an anvilassembly, illustrating sutures affixed thereto.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed buttress retention method forlinear endostaplers will now be described in detail with reference tothe drawings wherein like numerals designate identical or correspondingelements in each of the several views. As is common in the art, the term‘proximal” refers to that part or component closer to the user oroperator, i.e. surgeon or physician, while the term “distal” refers tothat part or component further away from the user.

Referring now to FIG. 1, there is disclosed a linear surgical staplinginstrument or surgical stapler 10 for use in stapling tissue andapplying layers of buttress material between the staples and underlyingtissue. An exemplary example of this type of surgical staplinginstrument is disclosed in U.S. Pat. No. 7,128,253, the entiredisclosure of which is incorporated by reference herein.

Surgical stapler 10 generally includes a handle 12 having an elongatetubular member 14 extending distally from handle 12. An end effector 100is secured on the distal end of elongate tubular member 14. End effector100 includes a cartridge assembly 200 housing a plurality of surgicalfasteners or staples 223 (see FIG. 2) and an anvil assembly 300 movablysecured in relation to cartridge assembly 200. Handle assembly 12includes a stationary handle member 22, a movable handle member 24, anda barrel portion 26. An articulation lever 30 is mounted on the forwardend of barrel portion 26 adjacent rotatable member 28 to facilitatearticulation of end effector 100. A pair of knobs 32 are movablypositioned along barrel portion 26. Knobs 32 are advanced distally toapproximate or close cartridge and/or anvil assembly 200, 300, andretracted proximally to unapproximate or open cartridge and/or anvilassembly 200, 300. Actuation of movable handle member 24 applies linesof staples 223 to tissue. In order to properly orient cartridge andanvil assembly 200, 300 relative to the tissue to be stapled, surgicalstapling apparatus 10 is additionally provided with a rotatable member28 on the forward end of barrel portion 26. Rotation of rotatable member28 relative to handle assembly 12 rotates elongate body 14 and loadingunit 100 relative to handle assembly 12 so as to properly orientcartridge assembly 200 and anvil assembly 300 relative to the tissue tobe stapled.

One or more buttresses are attached to the cartridge assembly, the anvilassembly, or both. For example, the cartridge assembly 200 is providedwith a cartridge buttress 500 a and anvil assembly 300 is provided withan anvil buttress 500 b in the manners described in more detailhereinbelow. A cartridge buttress retention system 250 (see FIG. 3) isprovided to releasably secure cartridge buttress 500 a to staplecartridge assembly 200. Likewise, an anvil buttress retention system 340(see FIG. 4) is provided to releasably secure anvil buttress 500 b toanvil assembly 300. Cartridge buttress 500 a and anvil buttress 500 band are provided to reinforce and seal staple lines applied to tissue bysurgical stapler 10.

The buttresses 500 a, 500 b may be made from any biocompatible naturalor synthetic material. The material from which the buttresses 500 a, 500b are formed may be bioabsorbable or non-bioabsorbable. It should beunderstood that any combination of natural, synthetic, bioabsorbable andnon-bioabsorbable materials may be used to form the buttress material.The buttresses 500 a, 500 b may be porous or non-porous, combination ofporous and non-porous layers. The non-porous buttresses 500 a, 500 b maybe utilized to retard or prevent tissue ingrowth from surroundingtissues thereby acting as an adhesion barrier and preventing theformation of unwanted scar tissue. The buttress materials may beprovided in the form of a sheet, a non-woven material, felt, mesh, foamor other form.

Additional exemplary materials for surgical buttresses 500 a, 500 b foruse with the surgical stapling devices disclosed herein are set forth incommonly assigned U.S. Pat. Nos. 5,542,594; 5,908,427; 5,964,774; and6,045,560, and commonly assigned U.S. Application Publication Nos.2006/0085034, filed on Apr. 20, 2006; and 2006/0135992, filed on Jun.22, 2006, the entire contents of each of which is incorporated herein byreference. Bio-absorbable polymers, non-bioabsorbable polymers,biologically appropriate metals, tissue-derived materials and compositesthereof may be used.

As seen in FIG. 2, cartridge assembly 200 includes a carrier 210defining an elongated support channel 212. Elongated support channel 212of carrier 210 is dimensioned and configured to selectively receive astaple cartridge 220 therein. Staple cartridge 220 includes retentionslots 222 formed therein for receiving a plurality of fasteners 223 andpushers 226. A central longitudinal slot 234 is formed in and extendsalong the length of staple cartridge 220 to facilitate passage of knifeblade 156 of drive bar 150 therethrough. During operation of surgicalstapler 10, actuation sled 228 translates through staple cartridge 220to advance the cam wedges into sequential contact with pushers 226, tocause pushers 226 to translate vertically within retention slots 222 andurge staples 223 from slots 222 into staple forming cavities of anvilplate 310 of anvil assembly 300.

Cartridge buttress 500 a of cartridge assembly 200 is operatively andreleasebly secured to a tissue contacting surface of staple cartridge220, by cartridge buttress retention system 250 wherein anchor members,which may comprise sutures “S1, S2,” overlie the tissue contactingsurface of the staple cartridge. In certain embodiments, the suturesoverlie retention slots 222 and/or at least a portion of a length oflongitudinal slot 234. A first anchor member or suture “S1” is affixed,as described in further detail hereinbelow, to staple cartridge 220 ofthe cartridge assembly and around/over distal portion of cartridgebuttress 500 a, and a second anchor member or suture “S2” is affixed tostaple cartridge 220 around/over proximal portion of cartridge buttress500 a. Other anchor members may be used, such as straps, sheets, wires,cables, threads, rods, etc.

As best seen in FIG. 3, cartridge assembly 200 is shown with cartridgebuttress 500 a affixed by cartridge buttress retention system 250.Cartridge buttress 500 a is positioned on the tissue contacting surfaceof staple cartridge 220. A first end of each anchor member or suture“S1, S2” is anchored or fixed to the staple cartridge assembly, and thesecond end of each suture is anchored or fixed to a second side surfaceof the staple cartridge assembly at attachment zones. For example, thefirst side surface 240 and second side surface of staple cartridge 220have respective distal and proximal overmolded zones 242 a, 244 a,provided near the distal and proximal portions of staple cartridge 220.A second end of each suture “S1, S2” passes transversely acrossrespective distal and proximal portions of cartridge buttress 500 a andis anchored or fixed to a second side surface 246, opposite first sidesurface 240, at respective distal and proximal overmolded zones 242 b,244 b, provided near the distal and proximal portions of staplecartridge 220. In this manner, sutures “S1, S2” are bonded to theovermolded zones and thus secure cartridge buttress 500 a underneath tothe tissue contacting surface of staple cartridge 220.

With reference again to FIG. 2, anvil assembly 300 includes an anvilplate 310 having a plurality of staple deforming pockets/cavities 310 a(see FIG. 4) and a cover plate 320 secured to a top surface of anvilplate 310. Anvil assembly 300 further includes a knife blade 330operatively interposed within the cavity defined between anvil plate 310and cover plate 320.

Similar to cartridge buttress 500 a, anvil buttress 500 b may beoperatively secured to a tissue contacting surface of anvil plate 310,by anvil buttress retention system 340. For example, sutures “S3, S4,”overlie anvil pockets 310 a and/or at least a portion of a length oflongitudinal slot 314. A third suture “S3” is affixed to the anvil plate310 around/over distal portion of anvil buttress 500 b, and a fourthsuture “S4” is affixed to anvil plate 310 around/over proximal portionof anvil buttress 500 b.

As shown in FIG. 4, anvil assembly 300 is shown with anvil buttress 500b affixed by anvil buttress retention system 340. Anvil buttress 500 bis positioned on the tissue contacting surface of anvil plate 310. Afirst end of each suture “S3, S4” is anchored or fixed to a first sidesurface 330 of anvil plate 310 extending from the tissue contactingsurface, at respective distal and proximal overmolded zones 332 a, 334a, provided near the distal and proximal portions of anvil plate 310. Asecond end of each suture “S3, S4” passes transversely across respectivedistal and proximal portions of anvil buttress 500 b and is anchored orfixed to a second side surface 336, opposite first side surface 330, atrespective distal and proximal overmolded zones 332 b, 334 b, providednear the distal and proximal portions of anvil plate 310. In thismanner, sutures “S3, S4 are bonded to the overmolded zones and thussecure anvil buttress 500 b underneath to the tissue contacting surfaceof anvil plate 310.

Bonding between the sutures and the overmolded zones of the cartridgebuttress retention system and the anvil buttress retention system may beachieved by ultrasonic welding, laser welding, solvent welding, heatpressing, or by other similar methods known in the art of plastic toplastic bonding. It is contemplated that the overmolded zones are madeof biocompatible plastic to which the sutures may optimally bond by thechosen bonding method. The overmolded plastic zones may be textured orgrooved to accept the sutures and to promote optimal bonding.Alternatively, attachment zones may be composed of press fit parts thatare attached to the anvil assembly, or attachment zones may be composedof molded features integral to the cartridge assembly.

Cartridge and anvil buttresses 500 are shown having a uniform profile.An example of this type of buttress is disclosed in U.S. PatentPublication No. 2011/0089220 filed on May 21, 2011, the entiredisclosure of which is incorporated by reference herein. The buttressesinclude a head portion 510, a body portion 520, and a neck portion 530interconnecting head portion and body portion. Body portion 520 definesa pair of opposing distal recesses 524 on transverse edges near a distalportion thereof. The pair of opposing distal recesses 524 are utilizedto secure the body portion to a distal portion of each of the anvilplate and the staple cartridge.

Similarly, body portion 520 further defines a two pairs of opposingproximal recesses 526 a, 526 b on transverse edges near a proximalportion thereof. The pair of proximal recesses 526, 526 b secure thebody portion to a proximal portion of each of the anvil plate and thestaple cartridge. The two pairs of proximal recesses allow thebuttresses to accommodate various types of profiles of the anvil andcartridge assemblies. While the buttresses have been shown herein havinga specific shape and design, it will be appreciated by those skilled inthe art, that the buttresses may have various shapes to secure to thetissue contacting surfaces of various anvil and cartridge assemblies.

In operation, with end effector 100 coupled to a distal end of elongatedbody 14 of surgical stapling apparatus 10, and with cartridge and anvilbuttresses 500 a, 500 b pre-loaded onto cartridge assembly 200 and anvilassembly 300, respectively, surgical stapling apparatus 10 is used inaccordance with methods known by those skilled in the art. Oncecartridge assembly 200 and anvil assembly 300 are clamped onto tissue,surgical stapling apparatus 10 is fired. In firing surgical staplingapparatus 10, drive bar 150 is advanced from a proximal-most position toa distal-most position of end effector 100. In so doing, knife blade 156of drive bar 150 enters notch 528 of buttresses 500 a, 500 b therebyfacilitating the dividing of buttresses 500 a, 500 b and reducing anyincidents of pushing or bunching-up of buttresses 500 a, 500 b by blade156. As drive bar 150 begins to travel distally, knife blade 156substantially simultaneously cuts through a central section of theproximal sutures “S2, S4” of cartridge assembly 200 and anvil assembly300, thereby respectively freeing the proximal ends of cartridge andanvil buttresses 500 a, 500 b therefrom. As knife blade 156 is moveddistally, knife blade 156 slices or cuts longitudinally through bothcartridge buttress 500 a and anvil buttress 500 b, thereby dividing thebuttresses 500 a, 500 b substantially in half.

Additionally, as drive bar 150 approaches the distal-most position,drive bar 150 and/or knife blade 156 engage sutures “S1, S3” and severdistal sutures “S1 or S3” and thus release a distal end of buttresses500 a, 500 b. In certain embodiments, a separate blade is mounted in thestaple cartridge assembly and/or anvil assembly for cutting the anchormember or suture.

Referring to FIG. 5, staple cartridge 220 and anvil plate 310 are shownwith the respective sutures affixed thereto without the buttresses. Thesutures of cartridge assembly 200 and anvil assembly 300 are selectivelypositioned such that proximal sutures “S2, S4” are located distally froma proximal end of longitudinal slots 234, 314. Similarly, distal sutures“S1, S3” are located proximally from a distal end of longitudinal slots234, 314. This allows knife blade 156 (FIG. 2) to sever proximal sutures“S2, S4” and distal sutures “S1, S3” as knife blade 156 translates alonglongitudinal slots 234, 314.

In certain other embodiments, the anchor member is welded, glued, orotherwise attached to the staple cartridge assembly and/or anvilassembly without the use of the overmolded material. For instance,attachment zones may be composed of press fit parts that are attached tothe anvil assembly, or attachment zones may be composed of moldedfeatures integral to the cartridge assembly. In addition, in any of theembodiments discussed herein, the anchor member or members arepermanently attached to the staple cartridge assembly and/or anvilassembly. However, in any of the embodiments disclosed herein, theanchor member or members can be temporarily attached to the staplecartridge assembly and/or anvil assembly so as to allow the anchormember to separate from the end effector to allow the buttress materialto be released.

It will be understood that various modifications may be made to theembodiments of the presently disclosed buttress retention system forlinear endostaplers. For example, the disclosed retention system is notlimited to a stapling apparatus but may find application in otherinstruments and situations requiring material to be releasably retainedon the surface of a surgical instrument. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of embodiments. Those skilled in the art will envisionother modifications within the scope and spirit of the presentdisclosure.

1-15. (canceled)
 16. An end effector for use with a surgical stapler,the end effector comprising: a staple cartridge having a tissuecontacting surface, a first side surface and a second side surfaceopposite the first side surface, wherein the first and second sidesurfaces each have polymeric overmolded zones disposed near a proximaland a distal portion thereof; an anvil plate having a tissue contactingsurface, a first side surface and a second side surface opposite thefirst side surface, wherein the first and second side surfaces each havepolymeric overmolded zones disposed near a proximal and a distal portionthereof; a buttress material releasably disposed on the tissuecontacting surfaces of each of the staple cartridge and the anvil plate;and a pair of sutures configured to retain the respective buttressmaterial atop the respective tissue contacting surfaces; whereinproximal sutures of the pairs of the staple cartridge and anvil platesutures are positioned along the proximal portion of each of the staplecartridge and anvil plate, and wherein distal sutures of the pairs ofsutures are positioned along the distal portion of each of the staplecartridge and the anvil plate; wherein each suture is bonded to arespective polymeric overmolded zone of the first and second sidesurfaces of each of the staple cartridge and anvil plate.
 17. The endeffector of claim 16, wherein each overmolded zone is integrally formedwith the respective staple cartridge and anvil plate.
 18. The endeffector of claim 16, wherein at least one overmolded zone is textured.19. The end effector of claim 16, wherein at least one overmolded zonedefines at least one groove.
 20. The end effector of claim 16, whereineach suture is a polymeric suture.
 21. The end effector of claim 20,wherein each polymeric overmolded zone is chemically compatible witheach polymeric suture.
 22. The end effector of claim 16, wherein eachsuture bond is an ultrasonic weld, laser weld or solvent weld.
 23. Theend effector of claim 16, wherein the staple cartridge further includesa plurality of staple retaining slots.
 24. The end effector of claim 16,wherein the staple cartridge further includes a central longitudinalextending knife slot.
 25. The end effector of claim 24, wherein thedistal suture on the staple cartridge is disposed proximal to thecentral longitudinal extending knife slot.
 26. A staple cartridgeconfigured for selective receipt in a jaw of a surgical stapler, thestaple cartridge comprising: a tissue contacting surface defining aplurality of staple retaining slots and a central longitudinal extendingknife slot; and a first side surface and a second side surface oppositethe first side surface; wherein the first and second side surfaces eachhave polymeric overmolded zones disposed near a proximal and a distalportion thereof.
 27. The staple cartridge of claim 26, wherein eachovermolded zone is integrally formed with the staple cartridge.
 28. Thestaple cartridge of claim 26, wherein at least one overmolded zone istextured.
 29. The staple cartridge of claim 26, wherein at least oneovermolded zone defines at least one groove.
 30. The staple cartridge ofclaim 26, further including a buttress releasably disposed on the tissuecontacting surface of the staple cartridge.
 31. The staple cartridge ofclaim 30, further including a pair of sutures traversing across aproximal and a distal end of the staple cartridge, wherein the pair ofsutures secure the buttress to the tissue contacting surface.
 32. Thestaple cartridge of claim 31, wherein each suture is bonded to arespective polymeric overmolded zone of the first and second sidesurfaces of the staple cartridge.